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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Very low levels of atherogenic lipoproteins and risk of cardiovascular events; a meta-analysis of statin trials</title><author><name sortKey="Boekholdt, S Matthijs" sort="Boekholdt, S Matthijs" uniqKey="Boekholdt S" first="S. Matthijs" last="Boekholdt">S. Matthijs Boekholdt</name><affiliation><nlm:aff id="A1">Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Hovingh, G Kees" sort="Hovingh, G Kees" uniqKey="Hovingh G" first="G. Kees" last="Hovingh">G. Kees Hovingh</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Mora, Samia" sort="Mora, Samia" uniqKey="Mora S" first="Samia" last="Mora">Samia Mora</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Arsenault, Benoit J" sort="Arsenault, Benoit J" uniqKey="Arsenault B" first="Benoit J." last="Arsenault">Benoit J. Arsenault</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Amarenco, Pierre" sort="Amarenco, Pierre" uniqKey="Amarenco P" first="Pierre" last="Amarenco">Pierre Amarenco</name><affiliation><nlm:aff id="A4">Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Pedersen, Terje R" sort="Pedersen, Terje R" uniqKey="Pedersen T" first="Terje R." last="Pedersen">Terje R. Pedersen</name><affiliation><nlm:aff id="A5">Center of Preventive Medicine, Oslo University Hospital, Ulleval and University of Oslo, Norway</nlm:aff></affiliation></author><author><name sortKey="Larosa, John C" sort="Larosa, John C" uniqKey="Larosa J" first="John C." last="Larosa">John C. Larosa</name><affiliation><nlm:aff id="A6">State University of New York Health Science Center, Brooklyn, New York (JCL)</nlm:aff></affiliation></author><author><name sortKey="Waters, David D" sort="Waters, David D" uniqKey="Waters D" first="David D." last="Waters">David D. Waters</name><affiliation><nlm:aff id="A7">Division of Cardiology, San Francisco General Hospital and the University of California at San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Demicco, David A" sort="Demicco, David A" uniqKey="Demicco D" first="David A." last="Demicco">David A. Demicco</name><affiliation><nlm:aff id="A8">Global Pharmaceuticals Pfizer, New York, New York</nlm:aff></affiliation></author><author><name sortKey="Simes, R John" sort="Simes, R John" uniqKey="Simes R" first="R. John" last="Simes">R. John Simes</name><affiliation><nlm:aff id="A9">NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Keech, Antony C" sort="Keech, Antony C" uniqKey="Keech A" first="Antony C." last="Keech">Antony C. Keech</name><affiliation><nlm:aff id="A9">NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Colquhoun, David" sort="Colquhoun, David" uniqKey="Colquhoun D" first="David" last="Colquhoun">David Colquhoun</name><affiliation><nlm:aff id="A10">The Wesley Hospital, Brisbane, Australia</nlm:aff></affiliation></author><author><name sortKey="Hitman, Graham A" sort="Hitman, Graham A" uniqKey="Hitman G" first="Graham A." last="Hitman">Graham A. Hitman</name><affiliation><nlm:aff id="A11">Centre for Diabetes, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Betteridge, D John" sort="Betteridge, D John" uniqKey="Betteridge D" first="D. John" last="Betteridge">D. John Betteridge</name><affiliation><nlm:aff id="A12">Department of Endocrinology and Diabetes, University College Hospital, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Clearfield, Michael B" sort="Clearfield, Michael B" uniqKey="Clearfield M" first="Michael B." last="Clearfield">Michael B. Clearfield</name><affiliation><nlm:aff id="A13">Touro University, Mare Island, California; Department of Medicine</nlm:aff></affiliation></author><author><name sortKey="Downs, John R" sort="Downs, John R" uniqKey="Downs J" first="John R." last="Downs">John R. Downs</name><affiliation><nlm:aff id="A14">University of Texas Health Science Center, San Antonio, Texas</nlm:aff></affiliation><affiliation><nlm:aff id="A15">VERDICT, South Texas Veterans Health Care System, San Antonio, Texas</nlm:aff></affiliation></author><author><name sortKey="Colhoun, Helen M" sort="Colhoun, Helen M" uniqKey="Colhoun H" first="Helen M." last="Colhoun">Helen M. Colhoun</name><affiliation><nlm:aff id="A16">Medical Research Institute, University of Dundee, Dundee, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Gotto, Antonio M" sort="Gotto, Antonio M" uniqKey="Gotto A" first="Antonio M." last="Gotto">Antonio M. Gotto</name><affiliation><nlm:aff id="A17">Weill Cornell Medical College, New York, New York</nlm:aff></affiliation></author><author><name sortKey="Ridker, Paul M" sort="Ridker, Paul M" uniqKey="Ridker P" first="Paul M." last="Ridker">Paul M. Ridker</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Grundy, Scott M" sort="Grundy, Scott M" uniqKey="Grundy S" first="Scott M." last="Grundy">Scott M. Grundy</name><affiliation><nlm:aff id="A18">Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas</nlm:aff></affiliation></author><author><name sortKey="Kastelein, John J P" sort="Kastelein, John J P" uniqKey="Kastelein J" first="John J. P." last="Kastelein">John J. P. Kastelein</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25082583</idno><idno type="pmc">4443441</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443441</idno><idno type="RBID">PMC:4443441</idno><idno type="doi">10.1016/j.jacc.2014.02.615</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">002020</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002020</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Very low levels of atherogenic lipoproteins and risk of cardiovascular events; a meta-analysis of statin trials</title><author><name sortKey="Boekholdt, S Matthijs" sort="Boekholdt, S Matthijs" uniqKey="Boekholdt S" first="S. Matthijs" last="Boekholdt">S. Matthijs Boekholdt</name><affiliation><nlm:aff id="A1">Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Hovingh, G Kees" sort="Hovingh, G Kees" uniqKey="Hovingh G" first="G. Kees" last="Hovingh">G. Kees Hovingh</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Mora, Samia" sort="Mora, Samia" uniqKey="Mora S" first="Samia" last="Mora">Samia Mora</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Arsenault, Benoit J" sort="Arsenault, Benoit J" uniqKey="Arsenault B" first="Benoit J." last="Arsenault">Benoit J. Arsenault</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author><author><name sortKey="Amarenco, Pierre" sort="Amarenco, Pierre" uniqKey="Amarenco P" first="Pierre" last="Amarenco">Pierre Amarenco</name><affiliation><nlm:aff id="A4">Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Pedersen, Terje R" sort="Pedersen, Terje R" uniqKey="Pedersen T" first="Terje R." last="Pedersen">Terje R. Pedersen</name><affiliation><nlm:aff id="A5">Center of Preventive Medicine, Oslo University Hospital, Ulleval and University of Oslo, Norway</nlm:aff></affiliation></author><author><name sortKey="Larosa, John C" sort="Larosa, John C" uniqKey="Larosa J" first="John C." last="Larosa">John C. Larosa</name><affiliation><nlm:aff id="A6">State University of New York Health Science Center, Brooklyn, New York (JCL)</nlm:aff></affiliation></author><author><name sortKey="Waters, David D" sort="Waters, David D" uniqKey="Waters D" first="David D." last="Waters">David D. Waters</name><affiliation><nlm:aff id="A7">Division of Cardiology, San Francisco General Hospital and the University of California at San Francisco, San Francisco, California</nlm:aff></affiliation></author><author><name sortKey="Demicco, David A" sort="Demicco, David A" uniqKey="Demicco D" first="David A." last="Demicco">David A. Demicco</name><affiliation><nlm:aff id="A8">Global Pharmaceuticals Pfizer, New York, New York</nlm:aff></affiliation></author><author><name sortKey="Simes, R John" sort="Simes, R John" uniqKey="Simes R" first="R. John" last="Simes">R. John Simes</name><affiliation><nlm:aff id="A9">NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Keech, Antony C" sort="Keech, Antony C" uniqKey="Keech A" first="Antony C." last="Keech">Antony C. Keech</name><affiliation><nlm:aff id="A9">NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Colquhoun, David" sort="Colquhoun, David" uniqKey="Colquhoun D" first="David" last="Colquhoun">David Colquhoun</name><affiliation><nlm:aff id="A10">The Wesley Hospital, Brisbane, Australia</nlm:aff></affiliation></author><author><name sortKey="Hitman, Graham A" sort="Hitman, Graham A" uniqKey="Hitman G" first="Graham A." last="Hitman">Graham A. Hitman</name><affiliation><nlm:aff id="A11">Centre for Diabetes, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Betteridge, D John" sort="Betteridge, D John" uniqKey="Betteridge D" first="D. John" last="Betteridge">D. John Betteridge</name><affiliation><nlm:aff id="A12">Department of Endocrinology and Diabetes, University College Hospital, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Clearfield, Michael B" sort="Clearfield, Michael B" uniqKey="Clearfield M" first="Michael B." last="Clearfield">Michael B. Clearfield</name><affiliation><nlm:aff id="A13">Touro University, Mare Island, California; Department of Medicine</nlm:aff></affiliation></author><author><name sortKey="Downs, John R" sort="Downs, John R" uniqKey="Downs J" first="John R." last="Downs">John R. Downs</name><affiliation><nlm:aff id="A14">University of Texas Health Science Center, San Antonio, Texas</nlm:aff></affiliation><affiliation><nlm:aff id="A15">VERDICT, South Texas Veterans Health Care System, San Antonio, Texas</nlm:aff></affiliation></author><author><name sortKey="Colhoun, Helen M" sort="Colhoun, Helen M" uniqKey="Colhoun H" first="Helen M." last="Colhoun">Helen M. Colhoun</name><affiliation><nlm:aff id="A16">Medical Research Institute, University of Dundee, Dundee, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Gotto, Antonio M" sort="Gotto, Antonio M" uniqKey="Gotto A" first="Antonio M." last="Gotto">Antonio M. Gotto</name><affiliation><nlm:aff id="A17">Weill Cornell Medical College, New York, New York</nlm:aff></affiliation></author><author><name sortKey="Ridker, Paul M" sort="Ridker, Paul M" uniqKey="Ridker P" first="Paul M." last="Ridker">Paul M. Ridker</name><affiliation><nlm:aff id="A3">Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Grundy, Scott M" sort="Grundy, Scott M" uniqKey="Grundy S" first="Scott M." last="Grundy">Scott M. Grundy</name><affiliation><nlm:aff id="A18">Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas</nlm:aff></affiliation></author><author><name sortKey="Kastelein, John J P" sort="Kastelein, John J P" uniqKey="Kastelein J" first="John J. P." last="Kastelein">John J. P. Kastelein</name><affiliation><nlm:aff id="A2">Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of the American College of Cardiology</title><idno type="ISSN">0735-1097</idno><idno type="eISSN">1558-3597</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">To evaluate (1) the inter-individual variability of reductions in low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) or apolipoprotein B (apoB) levels achieved with statin therapy, (2) the proportion of patients not reaching guideline-recommended lipid levels on high-dose statin therapy, and (3) the association between very low levels of atherogenic lipoproteins achieved with statin therapy and CVD risk.</p></sec><sec id="S2"><title>Background</title><p id="P2">Levels of atherogenic lipoproteins achieved with statin therapy are highly variable, but the consequence of this variability for cardiovascular disease (CVD) risk is not well documented.</p></sec><sec id="S3"><title>Methods</title><p id="P3">Meta-analysis of individual patient data from 8 randomized controlled statin trials in which conventional lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up.</p></sec><sec id="S4"><title>Results</title><p id="P4">Among 38,153 patients allocated to statin therapy, a total of 6,286 major cardiovascular events occurred in 5,387 study participants during follow-up. There was large inter-individual variability in the reductions of LDL-C, non-HDL-C and apoB achieved with a fixed statin dose. Over 40% of trial participants assigned to high-dose statin therapy did not reach an LDL-C target below 70 mg/dL. Compared to patients who achieved an LDL-C > 175 mg/dL, those who reached an LDL-C 75-100 mg/dL, 50-75 mg/dL and < 50 mg/dL had adjusted hazard ratios for major cardiovascular events of 0.56 (95%CI 0.46-0.67), 0.51 (95%CI 0.42-0,62) and 0.44 (95%CI 0.35-0.55), respectively. Similar associations were observed for non-HDL-C and apoB.</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">The reduction of LDL-C, non-HDL-C and apoB levels achieved with statin therapy displays large inter-individual variation. Among trial participants treated with high-dose statin therapy, over 40% do not reach an LDL-C target <70 mg/dL. Patients who achieve very low LDL-C levels have a lower risk of major cardiovascular events than those achieving moderately low levels.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8301365</journal-id><journal-id journal-id-type="pubmed-jr-id">4429</journal-id><journal-id journal-id-type="nlm-ta">J Am Coll Cardiol</journal-id><journal-id journal-id-type="iso-abbrev">J. Am. Coll. Cardiol.</journal-id><journal-title-group><journal-title>Journal of the American College of Cardiology</journal-title></journal-title-group><issn pub-type="ppub">0735-1097</issn><issn pub-type="epub">1558-3597</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25082583</article-id><article-id pub-id-type="pmc">4443441</article-id><article-id pub-id-type="doi">10.1016/j.jacc.2014.02.615</article-id><article-id pub-id-type="manuscript">NIHMS690311</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Very low levels of atherogenic lipoproteins and risk of cardiovascular events; a meta-analysis of statin trials</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Boekholdt</surname><given-names>S. Matthijs</given-names></name><degrees>MD PhD</degrees><xref ref-type="aff" rid="A1">*</xref></contrib><contrib contrib-type="author"><name><surname>Hovingh</surname><given-names>G. Kees</given-names></name><degrees>MD PhD</degrees><xref ref-type="aff" rid="A2">†</xref></contrib><contrib contrib-type="author"><name><surname>Mora</surname><given-names>Samia</given-names></name><degrees>MD MHS</degrees><xref ref-type="aff" rid="A3">‡</xref></contrib><contrib contrib-type="author"><name><surname>Arsenault</surname><given-names>Benoit J.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A2">†</xref></contrib><contrib contrib-type="author"><name><surname>Amarenco</surname><given-names>Pierre</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A4">§</xref></contrib><contrib contrib-type="author"><name><surname>Pedersen</surname><given-names>Terje R.</given-names></name><degrees>MD PhD</degrees><xref ref-type="aff" rid="A5">∥</xref></contrib><contrib contrib-type="author"><name><surname>LaRosa</surname><given-names>John C.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A6">¶</xref></contrib><contrib contrib-type="author"><name><surname>Waters</surname><given-names>David D.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A7">#</xref></contrib><contrib contrib-type="author"><name><surname>DeMicco</surname><given-names>David A.</given-names></name><degrees>DPharm</degrees><xref ref-type="aff" rid="A8">**</xref></contrib><contrib contrib-type="author"><name><surname>Simes</surname><given-names>R. John</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A9">††</xref></contrib><contrib contrib-type="author"><name><surname>Keech</surname><given-names>Antony C.</given-names></name><degrees>MBBS MSc</degrees><xref ref-type="aff" rid="A9">††</xref></contrib><contrib contrib-type="author"><name><surname>Colquhoun</surname><given-names>David</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A10">‡‡</xref></contrib><contrib contrib-type="author"><name><surname>Hitman</surname><given-names>Graham A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A11">§§</xref></contrib><contrib contrib-type="author"><name><surname>Betteridge</surname><given-names>D. John</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A12">∥∥</xref></contrib><contrib contrib-type="author"><name><surname>Clearfield</surname><given-names>Michael B.</given-names></name><degrees>DO</degrees><xref ref-type="aff" rid="A13">¶¶</xref></contrib><contrib contrib-type="author"><name><surname>Downs</surname><given-names>John R.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A14">##</xref><xref ref-type="aff" rid="A15">***</xref></contrib><contrib contrib-type="author"><name><surname>Colhoun</surname><given-names>Helen M.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A16">†††</xref></contrib><contrib contrib-type="author"><name><surname>Gotto</surname><given-names>Antonio M.</given-names><suffix>Jr</suffix></name><degrees>MD DPhil</degrees><xref ref-type="aff" rid="A17">‡‡‡</xref></contrib><contrib contrib-type="author"><name><surname>Ridker</surname><given-names>Paul M.</given-names></name><degrees>MD MPH</degrees><xref ref-type="aff" rid="A3">‡</xref></contrib><contrib contrib-type="author"><name><surname>Grundy</surname><given-names>Scott M.</given-names></name><degrees>MD PhD</degrees><xref ref-type="aff" rid="A18">§§§</xref></contrib><contrib contrib-type="author"><name><surname>Kastelein</surname><given-names>John J.P.</given-names></name><degrees>MD PhD</degrees><xref ref-type="aff" rid="A2">†</xref></contrib></contrib-group><aff id="A1"><label>*</label>Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands</aff><aff id="A2"><label>†</label>Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands</aff><aff id="A3"><label>‡</label>Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts</aff><aff id="A4"><label>§</label>Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France</aff><aff id="A5"><label>∥</label>Center of Preventive Medicine, Oslo University Hospital, Ulleval and University of Oslo, Norway</aff><aff id="A6"><label>¶</label>State University of New York Health Science Center, Brooklyn, New York (JCL)</aff><aff id="A7"><label>#</label>Division of Cardiology, San Francisco General Hospital and the University of California at San Francisco, San Francisco, California</aff><aff id="A8"><label>**</label>Global Pharmaceuticals Pfizer, New York, New York</aff><aff id="A9"><label>††</label>NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia</aff><aff id="A10"><label>‡‡</label>The Wesley Hospital, Brisbane, Australia</aff><aff id="A11"><label>§§</label>Centre for Diabetes, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom</aff><aff id="A12"><label>∥∥</label>Department of Endocrinology and Diabetes, University College Hospital, London, United Kingdom</aff><aff id="A13"><label>¶¶</label>Touro University, Mare Island, California; Department of Medicine</aff><aff id="A14"><label>##</label>University of Texas Health Science Center, San Antonio, Texas</aff><aff id="A15"><label>***</label>VERDICT, South Texas Veterans Health Care System, San Antonio, Texas</aff><aff id="A16"><label>†††</label>Medical Research Institute, University of Dundee, Dundee, United Kingdom</aff><aff id="A17"><label>‡‡‡</label>Weill Cornell Medical College, New York, New York</aff><aff id="A18"><label>§§§</label>Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas</aff><author-notes><corresp id="CR1"><bold><italic>Corresponding author:</italic></bold> J.J.P. Kastelein, MD PhD, Department of Vascular Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands, <email>j.j.kastelein@amc.uva.nl</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>18</day><month>5</month><year>2015</year></pub-date><pub-date pub-type="ppub"><day>5</day><month>8</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>26</day><month>5</month><year>2015</year></pub-date><volume>64</volume><issue>5</issue><fpage>485</fpage><lpage>494</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.jacc.2014.02.615</pmc-comment>
<abstract><sec id="S1"><title>Objectives</title><p id="P1">To evaluate (1) the inter-individual variability of reductions in low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) or apolipoprotein B (apoB) levels achieved with statin therapy, (2) the proportion of patients not reaching guideline-recommended lipid levels on high-dose statin therapy, and (3) the association between very low levels of atherogenic lipoproteins achieved with statin therapy and CVD risk.</p></sec><sec id="S2"><title>Background</title><p id="P2">Levels of atherogenic lipoproteins achieved with statin therapy are highly variable, but the consequence of this variability for cardiovascular disease (CVD) risk is not well documented.</p></sec><sec id="S3"><title>Methods</title><p id="P3">Meta-analysis of individual patient data from 8 randomized controlled statin trials in which conventional lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up.</p></sec><sec id="S4"><title>Results</title><p id="P4">Among 38,153 patients allocated to statin therapy, a total of 6,286 major cardiovascular events occurred in 5,387 study participants during follow-up. There was large inter-individual variability in the reductions of LDL-C, non-HDL-C and apoB achieved with a fixed statin dose. Over 40% of trial participants assigned to high-dose statin therapy did not reach an LDL-C target below 70 mg/dL. Compared to patients who achieved an LDL-C > 175 mg/dL, those who reached an LDL-C 75-100 mg/dL, 50-75 mg/dL and < 50 mg/dL had adjusted hazard ratios for major cardiovascular events of 0.56 (95%CI 0.46-0.67), 0.51 (95%CI 0.42-0,62) and 0.44 (95%CI 0.35-0.55), respectively. Similar associations were observed for non-HDL-C and apoB.</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">The reduction of LDL-C, non-HDL-C and apoB levels achieved with statin therapy displays large inter-individual variation. Among trial participants treated with high-dose statin therapy, over 40% do not reach an LDL-C target <70 mg/dL. Patients who achieve very low LDL-C levels have a lower risk of major cardiovascular events than those achieving moderately low levels.</p></sec></abstract><kwd-group><kwd>LDL-cholesterol</kwd><kwd>Non-HDL-cholesterol</kwd><kwd>Apolipoprotein B</kwd><kwd>Meta-analysis</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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| This area was generated with Dilib version V0.6.33. |  |